The leading cause of pneumonia in infants is a virus known as respiratory syncytial virus, or RSV. RSV is attributable to over 30 million new episodes of acute lower respiratory infection in infants and causes nearly 200,000 child deaths worldwide.

As one might guess, RSV and respiratory illness in general are the subject of many studies in developed countries like the United States. This isn’t the case in developing countries, where the information on RSV is lacking and access to prophylactic treatments is challenging at best. Besides, those treatments don’t “effectively modify the course of the disease” in cases of acute RSV. Then there is the fact that there is no vaccine for RSV, and studies in vaccine development are conflicting.

All of which means the deck is stacked against children living in least developed countries who contract RSV.

In the vaccine development world, RSV has been a high priority for some time. But an effective, affordable vaccine has yet to be developed. Fortunately, affordable health interventions (like vaccines) aimed at benefiting those living in developing countries is a funding specialty for the world’s largest foundation. Yes, we’re talking about Gates.

Before moving forward, we should mention that the Gates Foundation has been funding projects and programs related to RSV since awarding a $200,000 grant to the International Centre for Diarrhoeal Disease Research, Bangladesh, in 2009, so this is not uncharted territory for the foundation. Its latest grant to Novavax, however, is, as it is the largest grant Gates has awarded to date that is specifically for the development of an RSV vaccine.

The Gates Foundation awarded Novavax an up to $89 million grant to support the development of the RSV F vaccine and to defray the costs of a Phase 3 clinical trial in pregnant women. Gates is known for writing enormous checks to novel approaches in vaccine development, but it doesn’t do so without some type of data to back the potential success (or failure) of such work. This grant is no exception, and the data explains why the foundation cut such a huge check to Novavax—a first-time grantee.

Prior to the Gates grant, Novavax had already conducted a Phase 2 clinical trial related to maternal immunizations of RSV with the goal of protecting babies against the virus. The data resulting from the trial was enough to convince Gates to give Novavax a huge grant to support the next phase of its vaccine journey.

One more item of import, here, is that the Gates grant will also help Novavax jump through licensure hoops, which will hopefully set the organization on the path to the WHO prequalification process for vaccines. Predictably, the grant money will also go toward paying for the various fees charged by the WHO during the prequalification process.

If Novavax is successful in its RSV vaccine development, it has the potential to positively impact the health of hundreds of thousands, if not millions, of children around the world suffering from RSV, including those living in rich countries. This may be true, but the tie-in to developing countries, here, is that should Novavax be successful and receive licensure, it has agreed to make the vaccine affordable to LDCs. And making healthcare accessible and affordable in developing countries is something the Gates Foundation has always gotten behind.